Controlling cervical cancer
===========================

* Jeevan P. Marasinghe
* A.A.W. Amarasinghe

*   © 2007 Canadian Medical Association or its licensors

There has been striking progress in research into cervical cancer prevention. According to a CMAJ news article by Alicia Priest, a vaccine against human papillomavirus types 6 and 18 is about to be introduced in Canada.1 As Priest notes in the article, fears have been expressed that administration of the vaccine to young girls might increase sexual promiscuity.2 Moreover, there are concerns about how comfortable young women, parents and health care providers will be about discussing the vaccine.3

Despite the availability of the vaccine, policy-makers should not abandon more cost-effective methods of controlling the burden of cervical cancer,4 such as regular Papanicolaou screening and health education regarding the risk factors for human papillomavirus infection and the clinical problems and long-term complications associated with the infection. These methods have yet to be effectively implemented in some countries.5

After the vaccine is introduced, it will be a few years before a reduction in cervical cancer incidence is detectable. In the meantime, it is important to maintain the existing screening programs and to study the acceptability of the vaccine and the feasibility of the programs to administer it.

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1.  1. Priest A. Cervical cancer vaccine may come soon to Canada. CMAJ 2006;175(3):235.
    
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3.  3. Zimet GD. Understanding and overcoming barriers to human papillomavirus vaccine acceptance. Curr Opin Obstet Gynecol 2006;18(1 Suppl):23S-28S.
    
    

4.  4. Mandelblatt JS, Lawrence WF, Gaffikin L, et al. Costs and benefits of different strategies to screen for cervical cancer in less developed countries. J Natl Cancer Inst 2002;94(19):1469-83.
    
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5.  5. Monsoneqo J. Cervical cancer prevention: the impact of HPV vaccination. Gynecol Obstet Fertil 2006;34(3):189-201.
    
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